FACIAL TRAUMA

FACIAL TRAUMA

Dr. Saxon is uniquely trained to perform reconstruction after facial trauma. An injury to the face can be an emotional experience. Attention to both aesthetics and function are both essential components to treating the face after an injury for an excellent long-term recovery. Some examples of problems treated after facial injury include:

  • Facial lacerations and subsequent scarring
  • Lacerations inside the mouth
  • Broken nose
  • Fractured facial bones (eye socket, cheeks, forehead)
  • Fracture jaw bone

Some of the most common reasons for injury are car accidents, falls, altercations, and dog bites

Treatment of Soft Tissue Injuries of the Face

Superficial lacerations on the face can generate a lot of anxiety, and a repair that gives the best cosmetic result is very important. Since Dr. Saxon has specific training in facial plastic and reconstructive procedures, every stitch and every millimeter of skin closure has attention to detail. Some aspects of soft tissue injury to the face often not considered are the function of the nerve that moves the face (facial nerve), potential of tethering and lack of closure of the eye, and function of the salivary gland ducts in the cheeks which are all taken into consideration when repair is done.

At the time of injury, the wound is cleaned and closed in layers in a way that minimizes the tension on the closure and surrounding tissue. Antibiotics are given for one week since the wound is often contaminated with bacteria. After a week of healing, the sutures are removed, and patients are instructed to use sunscreen daily to minimize pigment at the laceration site.

Unlike incisions made in surgery, traumatic injuries to the face often require a second stage to refine the appearance either with a scar revision, dermabrasion, microneedling, etc.

Treatment of Nasal Fractures

The nose is the most prominent feature on the face and the most common bone broken in the face. Immediately after the injury, people often have a fairly severe nosebleed, and the nose is quite swollen. If not seen immediately, it is useful to wait 2-3 days for swelling to go down before determining whether a procedure is needed to straighten the nose. There are a couple of things to consider when trying to decide to fix a broken nose:

  1. Is the nose crooked?
  2. Is breathing worse after the injury?

Treatment of a nasal fracture, if needed, can be done within the first week of injury as a procedure in the office or after the bones have had time to heal (about 3 months). If not addressed in the first week, patients may require a formal rhinoplasty for repair.

Treatment of Facial Fractures

Fractures to the bones of the face are very different than a broken arm or leg. There is no way to put a cast on the face, so fractures are repaired in a number of different ways. This may be with a soft diet to not put tension on the broken segment while it heals, by titanium plates and screws, or by wiring the jaws together to temporarily immobilize the fracture.

Believe it or not, most areas of the face can be reached by incisions in the mouth. Occasionally, an incision in the brow or under the eyelid is necessary but heals nicely in these areas.

A CT scan is done at the time of initial evaluation and reviewed to determine the very best surgical plan.